Individual provider Active NPI

Julia L Reodica, RN, FNP-C

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1649693037
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F1013361 Issued in OR
Practice address
1012 SW Gaines St
Portland, OR 97239-7403
Phone
(858) 367-3672
NPI assigned
Jan 22, 2014
Last updated
Jan 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F1013361 OR Primary
Registered Nurse 163W00000X RN727268 CA
Registered Nurse 163W00000X 592944 NY
Critical Care Medicine Registered Nurse 163WC0200X 200943239RN OR

Addresses

Primary practice location

1012 SW Gaines St
Portland, OR 97239-7403

Mailing address

1012 SW Gaines St
Portland, OR 97239-7403
Phone (858) 367-3672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN727268CAMDRegistered Nurse
592944NYMDRegistered Nurse
200943239RNORMDCritical Care Medicine Registered Nurse
F1013361ORMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1649693037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 SW GAINES ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972397403",
            "telephone_number": "858-367-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 SW GAINES ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972397403",
            "telephone_number": "858-367-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REODICA",
        "first_name": "JULIA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "F1013361",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN727268",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "592944",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OR",
            "license": "200943239RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.